The increasing incidence of kidney disease in the U.S. and worldwide represents a major challenge to our health systems. There is a growing urgency to train physician scientists and Ph.D. scientists who can increase our understanding of disease pathogenesis and develop, implement and assess new therapeutic modalities to combat renal disease. The goal of the Vanderbilt Nephrology Training Program is to provide promising M.D. and/or Ph.D. postdoctoral fellows with the knowledge and the tools to become the leaders in both basic and translational research efforts to generate new understanding in the pathogenesis of kidney diseases and to develop and implement new treatments and cures for our patients with kidney disease. The faculty who participate in the Vanderbilt Nephrology Training Program represent a group of talented and accomplished researchers with a broad range of scientific expertise and research interests. This group consists of 25 investigators whose primary appointment is in either Adult or Pediatric Nephrology and 27 other clinical and basic scientists who have ongoing interests in kidney disease or associated scientific questions. The training faculty are based in 10 departments: Medicine, Pediatrics, Pathology, Cancer Biology, Surgery, Cell Biology, Biochemistry, Anesthesia and Biostatistics. Research interests of the primary faculty include mechanisms of chronic glomerular and tubulointerstitial injury, acute kidney injury, cell-matrix and cell-cell interactions, renal development, epithelial cell biology, eicosanoid biology, epidemiology of progressive kidney disease, development of clinical biomarkers, health services research and clinical trials. Our training program is structured to provide physician/scientist (M.D. or M.D/Ph.D.) and selected basic scientist (Ph.D) trainees with a focused and productive research experience that will serve as the foundation for an independent investigative career directed toward understanding and treatment of renal disease. Research opportunities for training in kidney disease have greatly expanded at Vanderbilt both within and outside of the Nephrology Division since the previous submission of this training program. In the present application, we are therefore requesting an increase in support from three to five postdoctoral trainees per year.